DR. HEMANT MODI
NPI 1033186267
Internal Medicine - Cardiovascular Disease in Parkersburg, WV

Q: What is Hemant Modi's NPI number?

The NPI number for Hemant Modi is 1033186267. It was assigned to this individual provider in the NPPES registry on March 7, 2006.

Q: What is Hemant Modi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Hemant Modi was last updated on April 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 07, 2006PECOS EnrolledAccepts Medicare Assignment

94.1/100

CMS Quality Rating

600 18TH ST, SUITE 512, PARKERSBURG, WV 26101(304) 424-4574(304) 424-4429 Get Directions Write a Review

NPPES record last updated: April 18, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 18, 2022, Jan 13, 2021 (2 updates tracked since 2021).

On this page

About Dr. Hemant Modi NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. HEMANT MODI (NPI 1033186267) is an individual cardiovascular disease provider in Parkersburg, West Virginia, licensed in West Virginia (15836) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Marietta Memorial Hospital, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1033186267

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameDR. HEMANT MODI

Location Address600 18TH ST, SUITE 512Parkersburg, WV 26101-3231

Mailing Address600 18th St, Suite 512Parkersburg, WV 26101-3231 · (304) 424-4574 · Fax (304) 424-4429

Phone(304) 424-4574

Fax(304) 424-4429

Sole ProprietorNo

Medical School CMSOtherGraduated 1982

Enumeration DateMarch 7, 2006

Last NPPES UpdateApril 18, 20222 updates tracked since enumeration

NPPES CertifiedApril 18, 2022

✔ NPI 1033186267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in WV · 15836

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

600 18TH ST, Parkersburg, WV 26101

Open in Google Maps ↗

Other Identifiers 1

Medicaid0072410000WV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Hemant Modi is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921083528

PECOS Enrollment IDI20100909000985

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Hemant Modi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Camden-Clark Physician Corporation

0.8 mi

Surgery

604 ANN ST
Parkersburg, WV 26101

Reassigned Medicare billing, West Virginia enrollment
461 clinicians in this Medicare group

NPI 1710125430 (304) 424-4593

Community Health Association

25 mi

Physical Therapy

511 WASHINGTON ST
Ravenswood, WV 26164

Reassigned Medicare billing, West Virginia enrollment
Also billed through NPI 1235753286 (West Virginia)
127 clinicians in this Medicare group

NPI 1124369780 (304) 273-5648

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 23

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

427 services371 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

318 services315 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

217 services190 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

184 services170 patients

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

166 services69 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

141 services127 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

98 services98 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

97 services97 patients

Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days 93244

A heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.

96 services94 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

78 services78 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

77 services77 patients

Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent G0250

This service involves your doctor evaluating your home INR (a blood clotting test) results. It's for patients with a mechanical heart valve, chronic atrial fibrillation, or venous thromboembolism who meet specific criteria. It helps manage your treatment, but tests aren't conducted frequently.

75 services45 patients

Heart rhythm recording continous external ekg over more than 48 hours up to 7 days 93242

This procedure involves wearing a device, an external EKG, for up to 7 days to continuously monitor your heart rhythm. It helps detect irregularities that may not occur during a standard EKG. The device is non-invasive and safe.

72 services69 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

71 services70 patients

Ultrasound of heart 93307

An ultrasound of the heart, also known as an echocardiogram, is a non-invasive procedure that uses sound waves to create images of your heart. This test allows your doctor to monitor how your heart and its valves are functioning. It's a safe, painless process that can help diagnose heart conditions.

64 services63 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

40 services39 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

39 services38 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

36 services35 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days 93248

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

30 services30 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

24 services20 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

19 services16 patients

Ct scan of blood vessels and grafts of heart with contrast 75574

A CT scan of the heart's blood vessels and grafts with contrast is a diagnostic test. A special dye (contrast) is injected into your veins, which helps create clear images of your heart's vessels and grafts. This helps doctors detect blockages or other abnormalities.

15 services15 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Marietta Memorial Hospital

Acute Care Hospitals · Marietta, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360147

Location401 Matthew StreetMarietta, OH 45750 · Washington County

Emergency services Birthing friendly

Camden Clark Medical Center

Acute Care Hospitals · Parkersburg, WV

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510058

Location800 Garfield AveParkersburg, WV 26101 · Wood County

Emergency services Birthing friendly

Jackson General Hospital

Critical Access Hospitals · Ripley, WV

OwnershipVoluntary non-profit - Private

CMS Certification Number511320

Location122 Pinnell StRipley, WV 25271 · Jackson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.46 typical visit price

range $53.20 – $164.59

Typical copayment $31.11 (range $13.30 – $41.14)

Most-billed visit code 99204

Established Patient

$66.84 typical visit price

range $16.47 – $133.29

Typical copayment $16.71 (range $4.11 – $33.32)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.1/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

78.46

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS MINIYA BERHANE M.D.

Pediatrics

600 18TH ST, SUITE 601
PARKERSBURG, WV 26101

Wood County (304) 424-4106

DIGESTIVE CARE CENTER, PLLC

Internal Medicine (Gastroenterology)

600 18TH ST, SUITE 401
PARKERSBURG, WV 26101

Wood County (304) 424-4330

MRS. LYNDSEY JANELL KUHN MSN, APRN, FNP-BC

Nurse Practitioner (Family)

600 18TH ST, SUITE 512
PARKERSBURG, WV 26101

Wood County (304) 424-4574

PAIN MANAGEMENT CENTER

Pain Medicine (Interventional Pain Medicine)

600 18TH ST
PARKERSBURG, WV 26101

Wood County (304) 422-4040

CHARLES F. WHITAKER MD INC.

Dentist

600 18TH ST, SUITE 304
PARKERSBURG, WV 26101

Wood County (304) 424-4961

PARKERSBURG FAMILY MED ASSOC PLLC

Family Medicine

600 18TH ST, SUITE 611
PARKERSBURG, WV 26101

Wood County (304) 424-4870

HENSHAW ORTHOPAEDICS, INC.

Orthopaedic Surgery

600 18TH ST, SUITE 610
PARKERSBURG, WV 26101

Wood County (304) 424-4741

DAVID ALAN GNEGY

Internal Medicine (Cardiovascular Disease)

600 18TH ST, SUITE 512
PARKERSBURG, WV 26101

Wood County (304) 424-4574

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hemant Modi's NPI number?

The NPI number for Hemant Modi is 1033186267. It was assigned to this individual provider in the NPPES registry on March 7, 2006.

Where is Hemant Modi located?

Hemant Modi practices at 600 18th St Suite 512, Parkersburg, WV 26101. The listed phone number is (304) 424-4574.

What is Hemant Modi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Hemant Modi enrolled in Medicare?

Yes. Hemant Modi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Hemant Modi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hemant Modi reassigns Medicare benefits to 2 organizations: Camden-Clark Physician Corporation (Parkersburg, WV) and Community Health Association (Ravenswood, WV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hemant Modi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hemant Modi accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Hemant Modi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Hemant Modi affiliated with any hospitals?

According to CMS data, Hemant Modi is affiliated with Marietta Memorial Hospital, Camden Clark Medical Center and Jackson General Hospital.

When was this NPI record last updated?

The NPPES record for Hemant Modi was last updated on April 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.